The 2025 report of the Lancet Countdown to 2030 for women's, children's, and adolescents' health: tracking progress on health and nutrition

Document Type

Article

Department

Centre of Excellence in Women and Child Health

Abstract

In line with previous progress reports by Countdown to 2030 for Women's, Children's, and Adolescents' Health, this report analyses global and regional trends and inequalities in health determinants, survival, nutritional status, intervention coverage, and quality of care in reproductive, maternal, newborn, child and adolescent health (RMNCAH) and nutrition, as well as country health systems, policies, financing, and prioritisation. The focus is on low-income and middle-income countries (LMICs) where 99% of maternal deaths and 98% of child and adolescent deaths (individuals aged 0–19 years) occur, with special attention to sub-Saharan Africa and South Asia.

Recognising the urgency of reaching the Sustainable Development Goal (SDG) for health, SDG 3, and health-related targets by 2030, the report assesses whether the momentum needed to reach these goals has been sustained, accelerated, stagnated, or regressed in comparison with the Millennium Development Goal (MDG) period (2000–15). Although most health and health-related indicators continue to show progress, there has been a notable slowdown in the rate of improvement after 2015, falling well short of the pace needed to achieve the 2030 SDG targets. This deceleration in pace contrasts sharply with the aspired grand convergence in health, characterised by drastic reductions in mortality and RMNCAH inequalities, which was expected to occur during the SDG period based on the assumption that the spectacular progress achieved during the MDG period would continue unabated. Multiple threats, external and internal to the RMNCAH health community, must be addressed to safeguard the gains in RMNCAH and nutrition and to accelerate progress. Furthermore, a large gap between sub-Saharan Africa, especially West and Central Africa, and other parts of the world persists for many indicators, necessitating further prioritisation of this region.

Deteriorating context for women's, children's, and adolescent's health The global health and development agenda, including RMNCAH and nutrition, is facing major obstacles. Economic trends are of great concern, including slowing economic growth, stagnating poverty reduction, and a major debt crisis. In 2021, 25 (58%) of 43 countries with data in sub-Saharan Africa spent more on public external debt servicing than health. Additionally, the pace of improvements in education and gender equity has slowed since 2015.

More countries are affected by armed conflicts and high numbers of battle-related deaths. In 2022, an estimated 327 million women and 507 million children lived near conflict zones, representing a 29% increase for women and a 24% increase for children since 2015. The number of women and children younger than 18 years uprooted by conflict increased from 46·3 million in 2015 to 80·7 million in 2023. Food insecurity has risen during the SDG period, fuelled by the COVID-19 pandemic, economic volatility, and armed conflict. Climate change, with its associated consequences of extreme weather events, infrastructure destruction, food insecurity, emerging diseases, and altered disease transmission patterns, poses a severe threat to women's, children's, and adolescents' health.

These crises and challenges are exacerbated by, and often contribute to, vast inequalities between and within countries. Women, children, and adolescents living in the least favourable social and economic environments, where multiple dimensions of inequality intersect, are the most vulnerable to the consequences of these challenges.

Publication (Name of Journal)

The Lancet

DOI

https://doi.org/10.1016/ S0140-6736(25)00151-5

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